Patients' Journey and Burden of Disease Among Patients with Psoriatic Arthritis in Greece: A Cross-Sectional Survey.

Abstract

Objective/aim: This study aims to explore the patients' journey from symptom onset to diagnosis and treatment and evaluate the humanistic and economic burden of Psoriatic Arthritis (PsA) in Greece.

Methods: A cross-sectional online survey was conducted with patients with PsA over 18 years old, members of the Greek patients' association "Reumazin". Data were collected through a structured questionnaire covering socio-demographics, medical history, patients' journey, health-related quality of life (HRQoL) using the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire, work productivity impairment, treatments, healthcare utilisation, and expenditures over the past 12 months. The economic burden included out-of-pocket expenses and indirect cost.

Results: A total of 148 patients with PsA participated, (70% female, median age 56 years). Median times from symptoms onset to rheumatologist visit, diagnosis, and treatment initiation were 11.5, 12.8, and 15.3 months, respectively. Most common initial symptoms were skin rash/psoriasis (77%) and joint pain (45%). Initial specialists visited included dermatologists (42%) and orthopaedics (21%), with 47% of patients initially misdiagnosed. The median PsAQoL score was 9.0 (Q1: 4.0, Q3: 13.0). Among employed participants (47%), median overall work impairment was 30%, and activity impairment was 40%. Mean annual out-of-pocket expenses were €609 (95% CI: €535 - €704), driven by treatment costs (70%). Indirect cost was €3,723 (95% CI: €2,906 - €4,859) with presenteeism accounting for 82%.

Conclusion: This study highlights diagnostic delays and the humanistic and economic burdens of PsA in Greece, providing insights into unmet needs to support healthcare providers and policymakers in improving patient care and resource allocation.